The differences between normal aging and dementia

WE’VE all experienced forgetful moments at some point. “Where did I put my keys? What time was that appointment again?” These moments are usually briefly stressful, and occur often without much thought given to them. As people age, they may even attribute these moments to “old age” and accept them as a normal part of their stage in life. But what if this is not always the case?

Short term memory loss, in many cases, can indicate the beginning of a brain illness called dementia. Dementia is a disorder affecting the brain causing difficulties with memory, thinking, judgment, language and problem solving which affects day to day living. Over half a million Canadians are currently dealing with some form of dementia, with that number set to grow steadily in the future.

Dementia includes various types, but the most common type is Alzheimer’s Disease. It makes up two-thirds of all dementia cases, and a majority of cases are seen in people over the age of 65.

It is important to know that one of the biggest risk factors for Alzheimer’s dementia is simply aging. It is estimated that every fourth person over the age of 85 will have Alzheimer’s dementia. This can make it difficult to distinguish whether the changes that we experience in our brain function and memory after age 65 represent normal aging, or signs of early dementia.

Below are some examples illustrating some of the key differences between normal aging and dementia:

Short term memory

Normal aging: A person forgets small details from a year ago, such as what they wore on a given day, or what was talked about over tea. They are still able to recall dates and events.

Dementia: A person forgets more important details from much more recently, such as whether medication was taken in the morning or where they were walking. They may leave the stove on or misplace money. Longer term memories are often still okay.

Learning new things:

Normal aging: A person has difficulty learning new information, such as how to use a new phone or latest gadget; generally still able to remember how to use day-to-day gadgets such as appliances.

Dementia: A person forgets information that was previously learned, such as how to use the phone, TV remote or toaster which they previously knew and operated many times before.

Language:

Normal aging: A person has occasional trouble finding the right word to describe something; vocabulary and comprehension remain intact.

Dementia: A person has more frequent difficulty finding words, resulting in frustrating conversation with starts and pauses; occasional usage of inappropriate words to describe something. Vocabulary becomes very limited.

Names and recognition:

Normal aging: A person forgets the name of someone they have only met once or twice, or the face of someone they have not seen for a long time.

Dementia: A person forgets the names of close relatives or friends; in advanced dementia, people can have trouble visually recognizing their loved ones.

Insight:

Normal aging: A person often feels their own memory is slipping, even if others don’t notice their difficulties.

Dementia: A person often denies being forgetful, and may even get offended if others start noticing their memory difficulties. They may make up stories to cover their memory loss in earlier stages. In some cases, there is no self-awareness of the memory loss.

Judgment:

Normal aging: A person’s judgment is preserved.

Dementia: A person’s judgment and decision making become impaired; decisions are often poor and result in actions without consideration of consequences.

Change in personality / behaviour:

Normal aging: A person may become less authoritative but their baseline personality and behaviour remain unchanged.

Dementia: A person’s personality can appear to completely change; they may become more aggressive, get angry or irritated easily; they can be argumentative, very emotional and at times blunt and socially inappropriate, and may come across as less thoughtful.

Perhaps the most important difference of all is that dementia affects a person’s ability to live and function independently. Normal aging is not characterized by significant memory loss or brain changes that affect daily living. Dementia can eventually reduce quality of life and can even threaten a person’s safety in later stages.

It is important to speak to your doctor if you suspect dementia in yourself or a loved one. To learn more, contact Baljeet Judge at the South Asian Dementia Helpline at 604-449-5003.

Over the next five months, Fraser Health will launch a series of live talks and articles to enhance dementia care in the community. Funding for this initiative is provided by the Specialist Services Committee (SSC), one of four joint collaborative committees representing a partnership of Doctors of BC and the BC Ministry of Health.

Please come out to Dr. Leena Jain’s podium talk at Laxmi Narayan Mandir on Sunday, November 26 at 1 p.m. to learn more about dementia.

Please watch for future articles in this series that will explore other topics related to dementia.